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Aortic Valve Surgery: New non-invasive method.

A REALLY good reason to stay healthy
When we think of maintaining our state of health, we are thinking about avoiding common everyday viruses that cause us cold and flu symptoms and major diseases that can kill us such as Type 2 diabetes, heart disease and cancer.
But there is another area where a very good state of health is required, and that is surgery. The rate at which you recover is inversely proportional to your state of health before the surgery started. In other words, the better shape you are in before the surgery, the quicker and more successful will be your recovery.
I was faced with this situation last month and this is my story of my operation and recovery.
I came from a poor family and when my parents passed away I had to take care of their final debts and there was no inheritance. However, during a routine ECG (electrocardiogram) test in 2009, I found out that my parents had left me something after all; a defective aortic valve.
The normal aortic valve has three cusps or flaps and is situated right in the middle of your heart looking like a Mercedes symbol. I was born with a bicuspid aortic valve (two flaps instead of three) and this forces the left ventricle of my heart to work much harder and become enlarged. It is usually noticed in your 40’s or 50’s but much later in my case because of my high level of physical fitness.
This leads to a condition known as aortic stenosis, a gradually thickening of the aortic valve and if left untreated can cause instant death. This happens when the blood can longer get through the small opening in the aortic valve and with no blood supply to the heart you are done for.
Once this condition was diagnosed, I simply stayed with my good diet, exercise and sleep regimen and saw my cardiologist once a year for an annual checkup. This year I was told that the opening of my aortic valve was becoming too constricted and it was time to replace the valve.
Be proactive about your health care
Once I knew that I was going to have a major operation I researched my options. In Toronto, at the Munk Cardiac Centre at Toronto General Hospital they had one of the best records of success. However, the downside was they broke open your breast plate and the recovery time was about 3 months.
I then learned that there was another method known as the less-invasive approach which did not break your breast bone at all. It required incisions from your chest and groin and the recovery period was about two weeks. Although this method can only be done with a bovine aortic valve as opposed to an aortic valve from a pig, it costs our government about $7000 more but that money is saved in the rehabilitation process.
My cardiologist was not aware of this relatively new procedure which was being done at Trillium Hospital in Toronto and at first refused to recommend it. However, being a very intelligent man with an open mind, he quickly made an appointment with a local surgeon here at Hamilton General hospital that was very skilled in this new procedure.
I was thrilled that I would have the less-invasive surgery and I was looking forward to it in spite of the fact I had no symptoms at all. Normally people with this condition are short of breath and have fainting spells but I kept on working, playing basketball and baseball, travelling and leading my normal everyday life.
I waited for such a long time for this surgery and was growing impatient. Once again, it is very important to be proactive in your health care. I found out that the only time they could do this type of surgery at Hamilton General hospital was when the special instruments required could be borrowed from the sales rep that sold these tools. I complained to my cardiologist who immediately found a wealthy contributor who purchased a set of instruments for the hospital and now they could schedule this procedure on a regular basis. The instruments were delivered to the hospital on December 15 and on January 15 of this year I had the procedure.
Operation
This procedure falls under the category of open-heart surgery. Making an incision just above my right breast and another one in the area of my right groin the surgeon makes his way toward my heart. Using a spreader, he pushes out my ribs and essentially removes my heart while running my body on a heart lung machine. He then replaces the bicuspid aortic valve with the new tricuspid bovine valve, places the heart back where it belongs, sutures it all together and restarts my heart as he removes me from the heart-lung machine. The operation took 6 hours to perform.
Recovery
You wake up from your procedure in the highest level Intensive Care Unit in which each patient has a specific nurse assigned to them. She was just a few inches from by bedside, injecting me with morphine every few hours to take away the pain caused by spreading my ribs and muscles. At first I panicked because I could not talk, but this was caused by a breathing tube down my throat. Eventually the tube was removed and I was put on oxygen
By the next day which was Friday, I was moved to the 5th floor, a less intensive ICU and by the end of that day I was breathing on my own and my catheter was removed. You are encouraged to move around and sit so that fluid does not accumulate in your lungs which could be a breeding ground for bacterial infections. This meant I was allowed to walk to the washroom and not use a urinal. Later that day, physiotherapists allowed me to walk around and go up and down some stairs while monitoring my blood pressure, heart rate and oxygen output. At noon on Saturday I was told that I was healthy enough to leave the hospital and go home. The surgeon who operated on me saw me at least 6 times after the operation and even changed my bandages himself.
The fact that I had open heart surgery on Thursday and was home by Saturday night is not only a tribute to my great surgeon but all the staff and nurses at Hamilton General Hospital and their great care. Also, as I stated earlier, I went in there in great physical condition and without any pre-existing disease states. I gave the surgeon and the staff a good subject to work with.
Home Recovery
One of the major side-effects of this surgery is water retention. Your kidneys provide all the electrolytes (sodium, calcium, potassium and magnesium) to provide the exact amount of electrical stimulus to drive your heart muscle. Once they realize the heart is gone, they refuse to allow any electrolytes to leave your body so they hold on to everything. This means that your fingers, wrists, ankles and feet are all swollen up with water; even areas of your face.
You also have a fair amount of pain around your rib cage and all the nearby muscles that have been traumatized but this pain dissipates very rapidly. Once out of the hospital I did not need any of the hydromorphone (Dilaudid) pain medication.
Medications
For a short period of time I will have to take some prescription medications; Furosemide 40mg (a diuretic to help remove the accumulated water in my body), a potassium supplement to make up for the loss of potassium caused by the diuretic, a very low-dose beta blocker to slow down my heart rate and keep my heart muscle from being overworked and an iron supplement until my haemoglobin is back to its normal level.
Supplements
I took my supplements up until the day before my surgery and was right back on them as soon as I was home.
My acetyl-L-carnitine 500mg and my Co Q 10 200mg to help with my energy level; my fish oil to help reduce inflammation in my body; my Quest Stress B with Vitamin C to restore energy all over my body; my Vitamin E 400 I.U. to keep delivering lots of fresh oxygen to my muscles, especially my heart muscle and my Vitamin D 1000 I.U. which I have been taking about 5 a day to speed up recovery.
It is important to understand that I would have not have been a candidate for this new procedure if my body type and size were not suited. In other words, if I was overweight, had a big pot belly, suffered from high blood pressure, Type 2 diabetes or COPD (chronic obstructive pulmonary disease) I would have had it done the old way and the risks would have been far greater. Not only that, the recovery time would have been extremely painful, requiring fistfuls of narcotics and a slow 3 month recovery.
Now that we are in the New Year and this is Heart month, think how prepared you would be if you required emergency or elective surgery. Most people want to lose weight, get in shape, eat better and get healthier for the New Year. Now I am giving you a new incentive; we are all living longer and better so prepare yourself for that new hip, new knee or even that new lense to replace the one with the cataracts. Complete all those healthy New Year’s resolutions for a successful operation and recovery that may come in the future.

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